目的：分析使用吻合器痔上黏膜环切术（PPH）治疗伴有出血的Ⅱ级痔的效果及其成本效益问题。方法以我院2012年1月~2013年1月收治的伴有出血的Ⅱ级痔患者110例为研究对象，随机分为A组和B组，A组行PPH术治疗，B组使用常规外剥内切术治疗，比较两组患者手术情况、术后疼痛情况、术后并发症及成本/效果（C/E）值。结果 A组患者手术时间、伤口愈合时间和术中出血量皆显著小于B组（P＜0.05）。A组疼痛水平得分亦显著低于B组（P＜0.05）。A组并发症发生率为7.27%，显著高于B组（21.82%），A组医疗费用显著高于B组，C/E显著低于B组（P＜0.05）。结论 PPH可以在伴有出血的Ⅱ级痔疮治疗中起到积极效果，其可降低疼痛水平，提高手术效果，减少术后并发症发生率，且其医疗成本效果更佳。%Objective To analyze the effect of procedure for prolapse and hemorrhoids (PPH) in the treatment of gradeⅡhemorrhoids with bleeding and its cost-effectiveness. Methods 110 patients with gradeⅡhemorrhoids with bleeding who were admitted to our hospital from January 2012 to January 2013 were selected as subjects. They were randomly allocated to group A and group B. Group A received PPH, while group B received regular hemorrhoidectomy. Surgery conditions, postoperative pain, postoperative complications and C/E values were compared between the two groups. Results Surgery time, wound recovery time and the amount of bleeding during surgery in group A were all significantly lower or shorter than those in group B (P<0.05). Score of pain level in group A were significantly lower than that in group B (P < 0.05). Incidence of complications in group A was 7.27%, significantly higher than that in group B (21.82%). Medical cost in group A was significantly higher than that in group B and C/E value was significantly lower than that in group B (P<0.05). Conclusion PPH has a positive effect in the treatment of grade II hemorrhoids with bleeding, reflected by lower pain level, better surgical effect, lower incidence of postoperative complications and better effect of medical cost.
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